Diastema: Symptoms, Types, Causes and Treatment

Diastema, the term for a gap or space between teeth, is a common dental occurrence that can affect both children and adults. While often considered a normal part of dental development—especially in children—diastema can also be a source of aesthetic concern and, less frequently, a sign of underlying dental or developmental problems. Understanding the symptoms, types, causes, and available treatments for diastema is essential for patients and dental professionals alike. The following article provides an in-depth, evidence-based overview of this condition.

Symptoms of Diastema

A diastema can be much more than just a visible gap between teeth. Its presence can influence oral health, aesthetics, and even psychological well-being. Recognizing the symptoms is the first step toward understanding when intervention may be necessary.

Symptom	Description	Impact	Source(s)
Visible Gap	Noticeable space between teeth	Aesthetic, Social	1 4 9
Speech Issues	Potential lisp or altered pronunciation	Functional	4 9
Food Trapping	Food caught in the gap	Oral Discomfort	6 9
Psychological	Self-consciousness or embarrassment	Emotional Health	4 9

Table 1: Key Symptoms of Diastema

Visible Gap Between Teeth

The hallmark sign of diastema is a visible space between two or more adjacent teeth. Most commonly, this occurs between the upper front teeth (maxillary central incisors) but can appear anywhere in the mouth 1 4 9. The size of the gap varies from minor to pronounced and is easily observed during a dental examination or when smiling.

Speech and Functional Issues

While many people with diastema have no functional problems, larger gaps—especially between the front teeth—can sometimes affect speech, leading to a lisp or altered pronunciation of certain sounds 4 9. This is more common in children as their teeth and jaws are still developing.

Food Trapping and Oral Discomfort

Diastema can contribute to food becoming lodged between teeth, leading to discomfort, bad breath, and sometimes an increased risk of gum disease if not cleaned properly 6 9. This symptom is more pronounced in cases where the gap is large or located between molars.

Psychological and Social Impact

The aesthetic aspect of diastema is significant for many people. Some may feel self-conscious or embarrassed about the appearance of their teeth, which can impact self-esteem and social interactions 4 9. In some cultures, however, diastema is seen as attractive or lucky.

Types of Diastema

Not all diastemas are the same. Their classification depends on their location, underlying cause, and whether their presence is temporary or persistent. Understanding the types helps guide appropriate diagnosis and treatment.

Type	Location/Characteristic	Typical Age/Condition	Source(s)
Midline	Gap between upper front teeth	Children & Adults	1 4 5 9
Generalized	Multiple gaps throughout dentition	Often genetic	3 4 9
Localized	Single gap, not at midline	Varies	3 9
Developmental	Occurs during mixed dentition phase	Children (temporary)	1 4 5 9

Table 2: Types of Diastema

Midline Diastema

The most commonly discussed type is the midline diastema, which appears between the two upper central incisors. In children, this is often a normal developmental phase as their permanent teeth erupt and settle 1 4 5 9. However, persistent midline diastema in adults may require evaluation and treatment.

Generalized Diastema

Some individuals exhibit generalized spacing, where multiple gaps are present throughout the upper or lower dental arches. This type is often related to a mismatch between jaw size and tooth size or genetic factors 3 4 9.

Localized Diastema

A localized diastema refers to a single gap not located at the midline. This may be due to missing teeth, abnormal tooth shape, or specific dental anomalies 3 9. Localized diastemas can occur anywhere in the dental arch.

Developmental Diastema

In children, diastema is frequently a normal part of dental development during the mixed dentition period, when both baby and permanent teeth are present. These gaps usually close as more permanent teeth erupt and align 1 4 5 9.

Causes of Diastema

Diastema can have a variety of causes, ranging from normal growth patterns to specific dental anomalies. Identifying the underlying cause is crucial for choosing the best treatment approach.

Cause	Mechanism/Explanation	Age Group Affected	Source(s)
Normal Development	Transitional phase in children	Children	1 4 5 9
Labial Frenum	Thick tissue between front teeth	Children & Adults	1 4 5
Supernumerary Teeth	Extra teeth preventing closure	Children	5 9
Tooth Size-Jaw Mismatch	Small teeth or large jaw	All ages	2 9
Oral Habits	Thumb sucking, tongue thrusting	Children	1 4 9
Dental Anomalies	Missing, peg-shaped, or undersized teeth	All ages	2 3 9
Periodontal Disease	Gum disease causing tooth movement	Adults	4 9

Table 3: Primary Causes of Diastema

Normal Development

In children, a diastema often forms naturally as part of the transition from baby to permanent teeth. This gap typically closes as the permanent canines erupt and align the front teeth 1 4 5 9.

Labial Frenum Attachment

An enlarged or low-attaching labial frenum (the tissue connecting the upper lip to the gums above the front teeth) has historically been blamed for many persistent midline diastemas. While it is a factor, it is not the sole or most common cause 1 4 5.

Supernumerary Teeth

The presence of extra (supernumerary) teeth, such as a mesiodens between the central incisors, can prevent normal closure of the gap 5 9. Removal of these teeth often allows the diastema to close naturally or with minimal intervention.

Tooth Size and Jaw Discrepancy

A mismatch between the size of the teeth and the jaw can lead to spacing issues. For example, small teeth in a large jaw or missing teeth can result in gaps 2 9. This cause often leads to generalized diastema.

Oral Habits

Certain habits—such as thumb sucking, tongue thrusting, or improper swallowing patterns—exert pressure on teeth and can contribute to the formation or persistence of diastema, especially in children 1 4 9.

Dental Anomalies

Abnormal tooth shapes (peg laterals), congenitally missing teeth, or undersized teeth are recognized contributors to diastema 2 3 9. These abnormalities can prevent the normal contact and alignment of adjacent teeth.

Periodontal Disease

In adults, gum disease can lead to loss of bone and gum support, causing teeth to move and resulting in the formation of spaces between teeth 4 9. This is more common with advancing age and poor oral hygiene.

Treatment of Diastema

The treatment of diastema is highly individualized. The optimal approach depends on the underlying cause, the size and location of the gap, the patient's age, and their personal preferences regarding aesthetics and function.

Treatment	Approach/Description	Best For	Source(s)
Observation	Monitoring, no intervention	Developmental cases	1 4 9
Orthodontics	Braces, aligners to move teeth together	Most types	3 4 8 9
Frenectomy	Surgical removal of labial frenum	Frenum-related diastema	1 2 4 5
Restorative	Bonding, veneers, crowns to close gap	Tooth size/shape issues	7 8 9
Extraction	Removal of supernumerary teeth	Supernumerary cases	5 9
Periodontal Therapy	Treating gum disease to stabilize teeth	Disease-related diastema	4 9
Retention	Devices to prevent relapse after closure	All treated cases	4 9

Table 4: Treatment Modalities for Diastema

Observation and Reassessment

In many children, especially those in the mixed dentition phase, no treatment is required as diastema may close naturally with the eruption of permanent teeth. Close monitoring is recommended to determine if intervention becomes necessary 1 4 9.

Orthodontic Treatment

Braces, clear aligners, or other orthodontic appliances are commonly used to close gaps, especially when multiple teeth are involved or when the diastema is significant. Orthodontics can also address underlying bite or alignment issues 3 4 8 9.

Frenectomy

If a thick or low-attaching labial frenum is identified as the primary cause of a persistent diastema, a minor surgical procedure called a frenectomy may be recommended. This is often combined with orthodontic treatment to ensure the gap remains closed 1 2 4 5.

Restorative Dentistry

For diastema caused by small or misshapen teeth, restorative options such as composite bonding, veneers, or crowns can be used to close the gap and improve aesthetics. Gingival recontouring may also be employed to enhance soft tissue appearance 7 8 9.

Extraction of Supernumerary Teeth

When an extra tooth is preventing closure of the diastema, extraction is generally advised. Following removal, orthodontic or restorative treatment may be needed to guide proper tooth alignment 5 9.

Periodontal Therapy

In cases where gum disease is the underlying problem, periodontal treatment is essential. Addressing inflammation and bone loss can help stabilize teeth and prevent the gap from worsening 4 9.

Retention

Regardless of the method used to close a diastema, retention is crucial to prevent relapse. Retainers or other stabilization devices are frequently prescribed following orthodontic or restorative treatment 4 9.

Conclusion

Diastema is a multifaceted dental condition with both developmental and pathological facets. Its significance ranges from a benign, self-resolving childhood phase to a source of aesthetic concern or an indicator of underlying dental issues in adults. Treatment is tailored to the individual's needs and the specific cause of the gap, and a thorough diagnosis is key to achieving a stable, lasting result.

Key Takeaways:

• Diastema most commonly presents as a visible gap between teeth, with possible functional and psychological impacts 1 4 9.
• Types include midline, generalized, localized, and developmental diastema, each with distinct characteristics 1 3 4 5 9.
• Causes range from normal growth, frenum attachment, supernumerary teeth, and oral habits to periodontal disease 1 2 3 4 5 9.
• Treatment is individualized, with observation, orthodontics, surgery, restorative dentistry, and retention among the key options 1 2 3 4 5 7 8 9.
• Accurate diagnosis and addressing the root cause are critical for successful, lasting closure of a diastema 1 2 4 9.

If you notice a gap between your teeth or are concerned about your or your child's dental development, a dental professional can provide a thorough evaluation and discuss the most suitable approach for your specific situation.